Motherhood, mental illness and beyond

Posts tagged ‘pregnancy’

First steps

DH and I have been together for 12 years now, and for all bar the first few weeks we’ve known that we both wanted children. At least 2, preferably 3 or 4 or even more. We decided on our favourite names in 2003 (our eldest wasn’t born until 2009!). For over a decade the prospect of having a large, chaotic, loving and happy family has always been a part of our plans. But not any more. Today, as a 33 year old mother of 2, I asked my GP to refer me to the local hospital to discuss sterilisation.

This is something I’ve discussed with my husband and my mother and I think it’s the right decision. I hope it is. The reason is very simple – as much as I yearn for more children I know that another pregnancy, another child, could endanger my life. My mental health has deteriorated over the last few years. I have suffered with post-natal depression after the birth of both my children, each time severe enough to make me suicidal. During my second pregnancy I had ante-natal depression which, while not as severe as the PND, still meant I was barely functioning. I wasn’t able to care for my daughter (then just 2) properly, I wasn’t able to care for myself and I certainly wasn’t able to care for the child I was carrying. As recently as March this year I was in crisis and suicidal; although I’ve recovered from that and feel stable again there’s always the possibility of a recurrence.

In addition to this, my physical health is poor. I suffered from awful PGP (pelvic girdle pain) in both pregnancies – the first time this meant I needed crutches to walk, the second time I was barely able to move by the third trimester. There’s also my spine to consider, as I have degenerative disc disease. I’d previously been told that if I wanted children I should have them before I was 30; the last consultant I saw was even more blunt and told me that if I wanted to retain the ability to walk I would limit my family to the 2 children I already have.

I know that sterilisation is a huge step to take, but to me it seems the logical one. For all the reasons listed above, if I should accidentally conceive I would have to abort the pregnancy. And I honestly don’t know if I could do that. But having conceived my son while correctly using contraception, I have very little trust in the usual methods of birth control. While I know that sterilisation isn’t a guarantee, it has far better odds of successfully avoiding pregnancy than anything else. My husband, lovely man that he is, has offered to have a vasectomy so that I don’t have to undergo a fairly major operation. But that seems unfair, to me. I’m the problem here, I’m the reason we can’t have more children. If DH and I ever split up or if I died, I would like him to find someone else and have the option of having more children if he wanted to. So I’ve said no.

I know that there will be people reading this who can’t have children, and who are probably screaming at the screen that I should be thankful for what I have. And I am, I really truly am. I realise that my pain is in no way comparable to that of someone unable to conceive or carry a pregnancy to term. But knowing that I will never have another child is very painful for me and I refuse to pretend otherwise.

DH and I have always been keen on fostering and that may be an option for us later on, if our mental illnesses aren’t a barrier. But I will never bear another child and I need to come to terms with that, somehow. Last week I took the first step and disposed of all the baby clothes and everything that DS has outgrown. Today I took the second. I’m not sure what the next step is but I hope it leads to not just acceptance, but peace.

Musings on depression and pregnancy

I read about a study this week that claims women who suffer from depression in pregnancy may pass the illness on to their children. The article in question on the mental health website Black Dog Tribe explains:

Researchers at the National University of Singapore asked 157 pregnant women to answer a questionnaire to ascertain their mental health during the 26th week of pregnancy. Within two weeks of birth their babies were given MRI scans to look at the structure of their brains – in particular the amygdala.
 
It was found that the mother’s level of depression had no effect on its volume. However, researchers found reduced ‘structural connectivity’, or abnormal wiring, in the right amygdala of infants of more depressed mothers. The finding suggests that abnormal amygdala function can be transmitted from mothers to babies before birth.
 
Researchers believe that a history of maternal depression might contribute to a tendency to the life-long increase in the vulnerability to mental illness in children.

Great. Wonderful. Women are already expected to exist in some weird sort of protective bubble while pregnant, constantly threatened with potentially disastrous outcomes for the unborn child if we even think about breaking the rules on eating, drinking, smoking, taking medication, exercising – the list seems endless. But now women must also worry that the state of their mental health may affect that of their child for life.

Don’t get me wrong, the research is interesting (although I would like to see a much larger and more thorough study examine the same question). If these conclusions are upheld then it becomes all the more important that mental health during pregnancy is monitored and the woman supported. But I worry about the impact that the publicity surrounding this study may have on women who are already struggling.

Post-natal depression (PND) is becoming much more prominent in the awareness of both the public and healthcare professionals. Although the media tend to sensationalise any news story where a mother is believed to have PND, it is becoming less stigmatised and pregnant women are usually given literature or at least a chat explaining the warning signs. Far less publicised though is its counterpart, ante-natal depression (AND).

I have suffered from both – PND twice and AND once. They were equally awful and traumatic but at least when I had PND I sort of knew what was going on. It was a “thing”, something I’d been warned about and that my husband had been on the lookout for given my history of depression. But I’d never heard of AND. When I plucked up the courage to tell my midwife how I was feeling it was dismissed as being down to my circumstances (an unexpected and difficult pregnancy, having a toddler, having to move twice in 4 months then claim benefits etc etc). A few weeks later a remarkably unsympathetic GP told me the same.

But I know now that it was AND. The sinking feeling every morning when I woke up still pregnant; the dread that I might miscarry warring with the dread that I might not; the certainty that I was ruining my daughter’s life. Instead of joy I felt disgust whenever the baby moved inside my expanding belly. I felt as though I was infested, occupied by an alien being, but I was rational enough to feel searing guilt as well. What kind of mother was I, to loathe my unborn child? True, the pregnancy was unexpected but we’d always planned to have another child at some point. I couldn’t understand why I felt the way I did but I knew it was wrong. At times I even felt suicidal but I didn’t act on those feelings because, ironically, I didn’t want harm to come to the baby.

Had I been told, back then, that I might be condemning my child to an increased risk of mental illness – well, it may well have tipped me over the edge. Studies like the one described above are necessary but when there is little or no support available for women who may have AND then they could be dangerous. I was so utterly ashamed of how I felt during that pregnancy that I barely spoke of it to anyone, especially after having my concerns summarily dismissed.

Why is PND becoming such a well-known illness but not AND? They’re two sides of the same coin, in my experience. The feelings of worthlessness, despair, shame, guilt and unrelenting misery are the same whichever side of the birth you are. Women and healthcare professionals need to be educated; they need to be taught that like PND, AND is a treatable illness and not a character flaw.

To any woman who’s reading this and is concerned that she may be suffering from ante-natal depression I say: you are not alone. You are not a bad person, nor are you or will you be a bad mother. Talk to someone about how you feel. Don’t be ashamed and certainly don’t worry about what one small study suggests. Far more research needs to be done in this area before the suggestion of a causal link even becomes a real possibility.

As for me, my son is now nearly 2 and is a happy, sunny little fellow. I try not to worry about what the future holds, mental health wise, for either him or his elder sister.

Musings on motherhood and mental health

When I discovered I was pregnant with DD I was thrilled. DH and I had wanted to start a family for years and so we spent the next 9 months in a state of perpetual excitement and anticipation, acquiring baby clothes and a cot and a Moses basket and a buggy and toys and all the other random paraphernalia that first-time parents are encouraged to think they need. We spent hours poring over my pregnancy book, looking at the pictures of the baby as she was at that moment (even from the early stages when the embryo resembles nothing so much as a mutant space prawn). We were prepared. Except – we didn’t think to do any reading about what it would be like to have a newborn. I mean, these things come naturally don’t they?

The labour was relatively uneventful and when DD was 9 hours old we found ourselves at home again, this time with a tiny person. That’s when the panic started to hit – we were responsible for keeping this tiny little creature alive. The only time I had been solely responsible for keeping anything alive was when I had a hamster at university. I looked down at baby DD and wondered just how transferable my hamster-looking-after skills were.

That first night was a blur. It hadn’t occurred to either of us that the baby wouldn’t sleep in the Moses basket – that’s what babies did after all! So why wouldn’t ours? DD fed well and grew well but continued to refuse to sleep in the basket for more than an hour at a time. Well-meaning friends and relatives gave us books about babies and being a parent. Great we thought – but all the books had conflicting advice. As did the aforementioned friends and relatives. Everyone had an opinion on what we were doing but no two people agreed.

By the time DD was 6 weeks old I was deep in the grip of postnatal depression. This wasn’t entirely unexpected as I have a long history of depression, so DH was on the lookout for any warning signs. The health visitor was less than helpful – she stood over me as I cradled my crying newborn and ordered me to put her to bed and leave her there. I refused. By the time the health visitor left I had the feeling that I had been marked down as trouble. For the next year if I went more than 4 weeks without taking DD to the baby clinic for weighing I would get a concerned phone call asking me to bring her along so she could be checked, or the health visitor would just turn up on my doorstep with the scales. I felt that they didn’t trust me to look after my own child – and I understood that because I was convinced I wasn’t capable of looking after her either.

I remember very little from DD’s first year but I do vividly remember one night. I remember DD screaming, and DH waking to find me crouched in a corner sobbing. I remember feeling thoroughly overwhelmed and despairing and convinced that it would be better if I died, that DD would be better off without any mother than she would with me. I was lucky – DH convinced me to seek help and I had a very sympathetic GP. She understood that I was extremely reluctant to take anti-depressants while breastfeeding and instead referred me for talking therapy and a course of computerised CBT. These helped a little.

But what helped most was the dawning realisation that although DD wasn’t a typical baby, there wasn’t anything wrong with her. There wasn’t anything wrong with the way we were looking after her. She just required more attention, physical contact and less sleep than most babies. (It wasn’t until DS was born and was exactly the same that I discovered the term ‘high-needs babies’. It was such a relief!). The pressures on new parents are immense. From the expectation that the mother will instantly regain her pre-baby figure to the endless (and ridiculous) ‘Is she a good baby?’ questions, from sleep deprivation to the endless stream of well-meaning but conflicting advice – well frankly I don’t know how anyone navigates the first few months of motherhood without cracking up!

I have gained confidence over the years and these days I have very little patience for society’s expectations of how my children will be. I do what works best for us and to hell with what anyone else thinks. I have no time for the competitiveness that seems so beloved of some parents – breast vs formula, cot vs co-sleeping, purée vs finger foods, strict routines vs benign neglect and all that. While it’s great to have confidence in how you are raising your child, thay doesn’t mean that someone doing it differently is doing wrong.

I am convinced that my lack of knowledge and the endless stream of conflicting advice and methods compounded my PND. Every time I thought I knew what I was doing there was another book or friend or ‘parenting guru’ (usually childless) to tell me otherwise. This is wrong. As a society we need to be more supportive of new parents, especially mothers on whom the main burden of care usually falls and who are recovering from the physical process of labour and birth. We need to care for their mental health as much as we care for their physical health, perhaps even more. The stitches I had after DD’s birth healed within weeks – I’m still recovering from the mental wounds.

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